Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.97 / $72.97 / $612.95	Facility		$72.97	$72.97	$612.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.66 / $72.97 / $72.97	Professional		$60.66	$72.97	$72.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $0.02 / $0.02 / $0.03	Facility		$0.02	$0.02	$0.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.04 / $208.11 / $247.01	Professional		$59.04	$208.11	$247.01
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $8.00 / $10.00 / $25.01	Professional		$8.00	$10.00	$25.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $136.94 / $136.94 / $136.94	Facility		$136.94	$136.94	$136.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.94 / $136.94 / $136.94	Professional		$136.94	$136.94	$136.94
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $129.94 / $129.94 / $155.93	Professional		$129.94	$129.94	$155.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $393.93 / $393.93	Professional		$393.93	$393.93	$393.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $369.49 / $1,378.85 / $1,429.09	Facility		$369.49	$1,378.85	$1,429.09
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,337.71 / $1,337.71 / $1,626.53	Professional		$1,337.71	$1,337.71	$1,626.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $192.51	Professional		$85.00	$85.00	$192.51
Providence Facility/Professional Facility Modifier Low / Median / High Price $72.97 / $136.94 / $351.25	Facility		$72.97	$136.94	$351.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $136.94 / $136.94 / $136.94	Professional		$136.94	$136.94	$136.94
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $129.94 / $142.93 / $220.90	Professional		$129.94	$142.93	$220.90
United Facility/Professional Professional Modifier Low / Median / High Price $83.51 / $83.51 / $161.69	Professional		$83.51	$83.51	$161.69